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Posted On : 25 Aug 2011

I Have a 13 yr old girl, who presented with obesity. Normal delivery, birth weight 3kgs, started to put on weight since young age. No obvious any psychiatric cause, no features of any hypothyrodism. Clinical examination
Weight 75kgs, ht 5.2feet, tanner 4 stage, no thyromegaly
systemic examination normal.
Inv showed TSH 18,8 with low T4 - pt on Eltroxine now 100mcg.
But 24hr urinary cortisol level is 460mcg, day, and 1mg overnight Dexa supression test show 8.8ng.

1} Do we wait and rpt test again
2}Do we go for LDDST .5mg and latter do a HDDST 2mg 6ht howebsitey and do serum cortisol with ACTH level pre and post test with 24hr urinary cortisol lvel in the last 24hrs of the test.

I would be greatful if you could answer my queries and reply. Waiting for your reply

Thanking you

Dr Harish

Expert Answer :

Answer Discussion :

S

Subhash

0

yes sir

13 years ago

Answer 1

Once the TSH is normal which will take about 6 weeks, repeat 6 am and midnight {12} cortisol and proceed with further tests only if the midnight cortisol is high

Dr. Vaman Khadilkar
Consultant Pediatric Endocrinologist

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